Critical Care & Emergencies (all articles)
No ICU beds? Expect double the number of Covid-19 deaths
14 Jan, 2021 | 02:05h | UTCNo ICU beds? Expect double the number of Covid-19 deaths. – Vox
Guideline: Malignant hyperthermia 2020
14 Jan, 2021 | 01:45h | UTCMalignant hyperthermia 2020: Guideline from the Association of Anaesthetists – Anaesthesia
A randomized trial of albumin infusion to prevent intradialytic hypotension in hospitalized hypoalbuminemic patients
14 Jan, 2021 | 01:42h | UTC
Confirmed reinfection with SARS-CoV-2 variant VOC-202012/01
13 Jan, 2021 | 02:30h | UTCConfirmed Reinfection with SARS-CoV-2 Variant VOC-202012/01 – Clinical Infectious Diseases
Commentary on Twitter
A new case report of reinfection with SARS-CoV-2 with the second episode due to the ‘new variant’ VOC-202012/01 of lineage B.1.1.7. The initial infection was mild illness while the second infection caused severe and critical illness. @InfectiousDz #CID https://t.co/hhP3gUnQSZ
— Antibiotic Steward? Bassam Ghanem (@ABsteward) January 9, 2021
Six RCTs to answer one question: what is the role of tocilizumab in COVID-19?
13 Jan, 2021 | 02:28h | UTCSix RCTs to answer one question: what is the role of tocilizumab in COVID-19? – PulmCrit
Related (study and commentaries): Randomized trial: Arthritis drugs improve survival in critically ill patients with Covid-19
HEAR or HEART Pathway – Can We Drop Troponin?
13 Jan, 2021 | 01:59h | UTCHEAR or HEART Pathway – Can We Drop Troponin? – Journal Feed
Original Study: Identification of very low-risk acute chest pain patients without troponin testing – Emergency Medicine Journal
Observational study: Surgical decompression within 24 h of acute spinal cord injury is associated with improved sensorimotor recovery
13 Jan, 2021 | 01:49h | UTCThe influence of timing of surgical decompression for acute spinal cord injury: a pooled analysis of individual patient data – The Lancet Neurology (link to abstract – $ for full-text)
Commentary on Twitter
.@TheLancetNeuro Surgical decompression within one day of acute #spinalcordinjury is linked with improved sensorimotor recovery. The first 24-36 hours following injury seem to represent a crucial time frame to reach optimal #neurological recovery. @UofT https://t.co/Fi53K2YKBk pic.twitter.com/RDESblOgoM
— Neurology Today (@NeurologyToday) December 28, 2020
Blood plasma treatment has limited effect for sickest COVID-19 patients
12 Jan, 2021 | 02:07h | UTCBlood plasma treatment has limited effect for sickest COVID-19 patients – Imperial College London
See also: Expert reaction to REMAP-CAP recruitment of severely ill COVID-19 patients into convalescent plasma trial being paused after initial analysis suggested it did not improve outcomes – Science Media Centre AND Trial of COVID-19 blood plasma finds no benefit in severely ill patients – Reuters
Randomized trial: Plasma therapy administered early is beneficial in high-risk elderly patients
12 Jan, 2021 | 02:05h | UTCCommentaries: Early convalescent plasma may lower risk of severe COVID in seniors – CIDRAP AND Covid-19: Early Plasma Treatment Improved Outcomes in Older Patients – Physician’s Weekly
Commentaries on Twitter
Just published @NEJM: A small, placebo-controlled randomized trial (N=160) of high IgG titer convalescent plasma administered early (within 72 hrs) for mild covid-19 to older adults (median age >70) shows benefit https://t.co/dhyFH4OwpH pic.twitter.com/14lMBBofUh
— Eric Topol (@EricTopol) January 6, 2021
Early convalescent plasma may lower risk of severe COVID in seniors@NEJM study finds that 16% of those treated with high-titer convalescent therapy developed severe #COVID19, compared with 31% in the placebo grouphttps://t.co/7hqCXsNHDM pic.twitter.com/dZDUwcjxUh
— CIDRAP (@CIDRAP) January 6, 2021
Randomized trial: Renin–angiotensin system inhibitors can be safely continued in patients admitted to hospital with COVID-19
12 Jan, 2021 | 01:59h | UTC
NEW Research—renin–angiotensin system inhibitors can be safely continued in patients admitted to hospital with #COVID19
RCT from Julio Chirinos & colleagues https://t.co/ZNfqJ0NsRK pic.twitter.com/Kpg6xSsWKl
— The Lancet Respiratory Medicine (@LancetRespirMed) January 8, 2021
Cohort study: Prevalence and risk factors for delirium in critically ill patients with COVID-19
12 Jan, 2021 | 01:55h | UTCCommentaries: Sedation in mechanically ventilated patients with COVID-19 – The Lancet Respiratory Medicine AND Large study finds higher burden of acute brain dysfunction for COVID-19 ICU patients – Vanderbilt University Medical Center
Artificial intelligence in telemetry: What clinicians should know
12 Jan, 2021 | 01:21h | UTCArtificial intelligence in telemetry: what clinicians should know – Intensive Care Medicine
Commentary on Twitter
New life for vital signs! Telemetry data ubiquitous in critical care, most collected by virtue of #ICU admission#ArtificialIntelligence advances unlocking potential of these to inform diagnosis & guide targeted treatment https://t.co/rkgHLJgH0R#MachineLearning #DataScience #AI pic.twitter.com/mgVDHMhE2n
— Intens Care Med (@yourICM) January 2, 2021
[Preprint] Randomized trial: Arthritis drugs improve survival in critically ill patients with Covid-19
10 Jan, 2021 | 20:56h | UTCCommentaries: Covid-19: Arthritis drugs improve survival in intensive care patients, shows study – The BMJ AND Arthritis drugs could help save lives of Covid patients, research finds – The Guardian AND Expert comment – Two potentially life-saving drugs for critically ill COVID-19 patients – London School of Hygiene & Tropical Medicine
Commentary on Twitter
Two rheumatoid arthritis drugs will now be used to treat the patients with severe covid-19 in intensive care, after new findings have shown that they significantly improve survival and cut the time spent in hospital by a week to 10 days https://t.co/cxNM64L5S6
— The BMJ (@bmj_latest) January 8, 2021
Randomized trial: Neutralizing monoclonal antibody not efficacious among hospitalized patients with covid-19
10 Jan, 2021 | 20:55h | UTCCommentaries: Covid-19: Trial of LY-CoV555 Stopped for Futility – Physician’s Weekly AND Results of NIH-sponsored ACTIV-3 trial published – NIH News Releases AND Bamlanivimab Flops in Hospitalized COVID-19 Patients – MedPage Today (free registration required)
[Press release – results not published yet] International trials of blood thinners in critically ill COVID-19 patients pause due to futility
10 Jan, 2021 | 20:44h | UTC
Commentary on Twitter
The 3 largest RCTs of therapeutic #anticoagulation for #COVID19 pts in the ICU have ALL been stopped early for futility. (@remap_cap @ATTACC_COVID & #ACTIV4)
Nothing published yet, but given the large n of these RCTs, I'm increasingly skeptical about anticoagulation in COVID19. pic.twitter.com/RrLSoOsp3v
— Nick Mark MD (@nickmmark) December 22, 2020
Randomized trial: Ultra-early tranexamic acid does not improve outcomes after subarachnoid hemorrhage
10 Jan, 2021 | 21:02h | UTCUltra-early tranexamic acid after subarachnoid haemorrhage (ULTRA): a randomised controlled trial – The Lancet (link to abstract – $ for full-text)
Tranexamic acid treatment in spontaneous subarachnoid haemorrhage, started immediately after CT diagnosis and continued until start of the aneurysm treatment as early as possible, does not improve clinical outcome, finds new randomised controlled trial: https://t.co/R0AhtszaY5 pic.twitter.com/Bnft9XgBA9
— The Lancet (@TheLancet) December 22, 2020
Meta-analysis: Effectiveness of bundle interventions on ICU delirium
10 Jan, 2021 | 20:16h | UTCEffectiveness of Bundle Interventions on ICU Delirium: A Meta-Analysis – Critical Care Medicine
Commentary: ICU bundles do not appear to improve delirium but may help other outcomes – ACP Hospitalist
Commentary on Twitter
Meta-Analysis incl 11 studies and 26,384 patients for bundle-interventions of delirium treatment showed no effects on delirum duration ( –1.42 d; 95% CI –3.06 to 0.22) or prevalence (risk ratio = 0.92; 95% CI, 0.68–1.24)https://t.co/PzZBGttOL8
— Peter Nydahl (@NydahlPeter) December 18, 2020
NICE Guideline: Do not use Vitamin D to prevent or treat COVID 19
18 Dec, 2020 | 10:03h | UTCCOVID-19 rapid guideline: vitamin D – National Institute for Health and Care Excellence
News release: NICE, PHE and SACN publish rapid COVID-19 guidance on vitamin D
Commentaries: Covid and vitamin D: ‘Not enough evidence’ for treatment – BBC AND Covid-19: Evidence is lacking to support vitamin D’s role in treatment and prevention – The BMJ
Commentary on Twitter
New NICE guidance:
“1.2 Do not offer a vitamin D supplement to people solely to prevent COVID-19, except as part of a clinical trial.
1.3 Do not offer a vitamin D supplement to people solely to treat COVID-19, except as part of a clinical trial.” https://t.co/AsTZF2xgYA— onisillos sekkides (@onisillos) December 17, 2020
“Racial Bias in Pulse Oximetry Measurement”. In two large cohorts, Black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry as White patients
18 Dec, 2020 | 10:01h | UTCRacial Bias in Pulse Oximetry Measurement – New England Journal of Medicine
Commentary: Devices Used In COVID-19 Treatment Can Give Errors For Patients With Dark Skin – NPR
Commentary on Twitter (thread – click for more)
1/ Our research letter on racial bias in pulse oximetry measurement, out today in NEJM https://t.co/6dLuNGosxp pic.twitter.com/XXsfWfc5dv
— Michael Sjoding (@msjoding) December 17, 2020
COVID 5 times deadlier than flu for hospital patients, study finds
18 Dec, 2020 | 09:53h | UTCCOVID 5 times deadlier than flu for hospital patients, study finds – CIDRAP
Commentary on Twitter
Among people admitted to hospital, #COVID19 was associated with increased risk of various extrapulmonary clinical manifestations, compared with seasonal influenza #BMJResearch https://t.co/R0J9HCvsH2
— The BMJ (@bmj_latest) December 16, 2020
Brazilian guidelines for the management of brain-dead potential organ donors
17 Dec, 2020 | 09:00h | UTC
Randomized trial: Dexamethasone for chronic subdural hematoma resulted in fewer favorable outcomes and more adverse events than placebo at 6 months
17 Dec, 2020 | 09:02h | UTCTrial of Dexamethasone for Chronic Subdural Hematoma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: Dexamethasone should be avoided in patients with chronic subdural haematoma – University of Cambridge AND Dexamethasone for Chronic Subdural Hematoma? – NEJM Journal Watch
Commentary on Twitter
In a trial that compared a 2-week course of dexamethasone with placebo in patients with a chronic subdural hematoma, a favorable outcome on the modified Rankin scale at 6 months was more common in the placebo group than in the dexamethasone group.
— NEJM (@NEJM) December 17, 2020
Randomized trial: In small infants, orotracheal intubation assisted with video laryngoscopy improves first-attempt success rate and reduces complications
17 Dec, 2020 | 08:56h | UTCFirst-attempt success rate of video laryngoscopy in small infants (VISI): a multicentre, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter
Fascinating paediatric VL study
VL
-improved FPS (esp <6.5kg)
& reduced
-attempts
-failures
-manipulations
-complications
-severe complicationsThe evidence grows that VL is simply better
Everywherehttps://t.co/f9nj6l2zk3— Tim Cook (@doctimcook) December 11, 2020
Randomized trial: In surgical patients at moderate or high risk of venous thromboembolism, pharmaco-thromboprophylaxis alone is as good as the combination of pharmaco-thromboprophylaxis and graduated compression stockings
16 Dec, 2020 | 10:00h | UTC
Observational study suggests we should individualize blood pressure targets among critically ill patients with different ranges of pre-illness baseline mean perfusion pressure
16 Dec, 2020 | 10:01h | UTCCommentary: Personalized Pressors – REACT Study Group – Journal Feed